As time goes by and my life experience increases and deepens, I realize more what it means to let go and let God. Before now, I was unaware of all the silent demands I placed on people, places and things to behave and exist in a way I deemed acceptable. Discomfort and pain are my signals today that something is misaligned in my thinking, rather than in my life. I understand that rather than expecting outside conditions to change, I just might need to adjust my attitude and expectations.

It is a blessing to have that understanding. This understanding enables me to loosen my grip on what I prefer things to be and, instead, embrace what my Higher Power offers me. When I want others to act a way that will provide me more comfort, delight, security, etc -and they can't or won't act that way- I now accept things as they are, trust there is an opportunity to grow and look to adjust my perspective of God's goodness in my life. I ask myself questions like "How might this person, place or thing be a teacher for me? What lessons can I learn from this experience? What is this person, place or thing forcing me to address that I hoped to ignore or avoid?"

Recovery has taught me that when I am placing demands I am acting like a toddler having a tantrum. More than likely, God knows exactly what I need and when I stop pounding my closed fists on the table, he can gently place his goodness in my lap.

My husband and son are asleep after a fantastic night in the neighborhood trick or treating. I love anything, including a holiday, which accentuates innocence and imagination. I love the amazing costumes. I love the taste of banana chews. I love the chill in the airl. I love coming home after the long evening and having a bowl of cereal, instead of a line of cocaine.

Halloween was one of those big party nights for me when I was still out there using cocaine and alcohol. I loved to dress up and pretend to be someone else. I loved the strange vibe in the air and the parties. I thought I was having such a good time until I realized addiction tricked me.

I don't miss hiding the baggies in my costume and snorting lines in a bathroom stall. I don't miss smoking packs of cigarettes because I couldn't stop. I don't miss grinding my jaw and making a fool out of myself. I don't miss blackouts and not remembering where i went or how I got home. I don't miss the wretching from too much booze, the hangovers or the spent money.

Recovery has treated me with the ability to walk my son by the hand around the neighborhood with my head held up high. No one today would imagine or believe the hell I experienced. For a moment tonight I thought, boy it would be nice to be having a glass of wine and a little blow. Then, my recovery voice laughed and replied, "What glass of wine? You would have chugged the whole bottle if you were using cocaine. You wouldn't be at a party. You would be delusional, paranoid, wired and wacked out. You would be miserable, alone and desperate. You ended up in an emergency room from your last party for goodness sake! What do you miss?"

Like I said, recovery is a treat and addiction is full of tricks. Luckily, I don't fall for those tricks anymore.

If I spend time thinking about the various issues specific to addicted clients I come up with a few central themes. Many people need to find a sense of purpose, some need to find a sober place to live, and others need to find a way to earn income or repair family relationships. However, what is needed to follow-through on any of these tasks is a sense of self-esteem, or what I like to call ‘Emotional Competence’ or EC. I think of of EC in this way: are you up to the task at hand? Do you have the ability and wherewithal to follow-through? It seems to me that if you don’t like who you are and you can’t take ownership of the successes in your life then it’s very likely you’ll never like who you are. I am convinced that there is a direct relationship between poor self-esteem and giving away all of the credit in your life to a higher power.

While there are many causes of poor self-esteem, I am not convinced it is necessary that you need to know why you dislike yourself. All of the reasons we dislike who we are tend to manifest in the same way and the end result is the same: poor self-esteem, diminished self-confidence, and a poor self-concept. Rather than focus on changing the past (which is generally impossible) let’s use this time to focus on how we can feel better about our place in the world. I want to posit seven ideas for change. It’s important to try and change how you feel about yourself as poor self-esteem can lead to relapse.

1) Sentence completions: on a piece of paper start with a sentence that says “I like myself because” and complete the sentence as many times as you are able. If you feel blocked you can try “I could like myself if…..” and complete several sentences. Note any patterns and share what you learned with a trusted friend or mentor and ask for feedback.

2) Affirmations: I could spend hours writing about affirmations so I will simply encourage you to look online for ways to create affirmations. When you complete affirmations just remember: they need to be said in the present, they need to be realistic, and they need to include a level of risk. When I say ‘level of risk’ I am simply suggesting that you can read them aloud, read them to yourself in a mirror, write them on a piece of paper, read them into a tape recorder and play them back, or you can go for the highest level of risk and read them to another person.

3) Forgiveness: I suspect we all have done things which are less than flattering to our ego. It will be likely that many times the stupid thing you have done will simply work itself out and people will see that you made a mistake and will be able to let go of their annoyance about you and your actions, so take heart in that. Other times the act perpetrated against us is so great that forgiveness seems like too huge a leap – perhaps we can begin by remembering that forgiveness is about forgiving the person and not the act. Seek more support if this is a block to you.

I wanted to share some of my feelings around the recent loss of a man who was loved by world. He loved to make us smile, laugh, cry, and giggle. A man who cared so much for others, including our Armed Forces around the world. He gave of his time generously, and we all never knew how much he was suffering on the inside. I shared some of this on my own personal recovery blog a few days ago, and it hits on some key points that we all as human beings can learn from. Of course, I'm talking about Actor & man of Comedy, Robin Williams.

Life just all on it's own can be a journey of good and bad, trials and tribulations, happiness and blessings, but when we see someone on the outside,we really never know what's really going on inside. I also talk in my blog post about the Stigma around the issues of Recovery, Addiction, Mental and Emotional illness and disorders. Which these same issues and a few more were part of the why's that took his life ...

“Robin Williams, Actor & Comedian describes his lifelong struggle with addiction that today is a ‘Haunting Awareness’ he had about recovery from addictions. . It’s a recovery legacy, an addiction awareness that he left for those of us who live life in recovery. Even though he lost HIS battles yesterday of addiction, recovery, and battle with mental health issues, he left this message, these past quotes for all of us to know, understand, and take to heart. . When will this trend of suicides due to ‘Dual Diagnosis’ of addiction relapse & mental illness? It’s time to STOP the government CUTS to proper Mental/Emotional Health & Recovery Services from Addictions! There are thousands of us out here who are not famous, or have the money for these almost always very expensive recovery and mental health services and treatment centers. But even when you have the $$$$, like Mr. Williams, guess it really didn’t help him now did it? . .Snippets Of Mental Illness, Addiction & Recovery After Thoughts In His Own Words…

It’s not easy, and it’s a very POWERFUL example of the daily battles we can have, and even long-term recovery people can have a life threatening RELAPSE at anytime. .“It waits,” he told “Good Morning America” in 2006. “It lays in wait for the time when you think, ‘It’s fine now, I’m OK.’ Then, the next thing you know, it’s not OK. Then you realize, ‘Where am I? I didn’t realize I was in Cleveland.”.

Williams, the comic whirlwind known for his hilarious stream-of-consciousness ramblings, was found dead Monday after the 63-year-old hung himself in his San Francisco Bay Area home in perhaps his final attempt to silence the demons that relentlessly targeted him. .”Cocaine for me was a place to hide. Most people get hyper on coke. It slowed me down,” he told People in 1988. .

“The Belushi tragedy was frightening,” Williams told People. “His death scared a whole group of show-business people. It caused a big exodus from drugs. And for me, there was the baby coming. I knew I couldn’t be a father and live that sort of life.”.

“I was in a small town where it’s not the edge of the world, but you can see it from there, and then I thought: drinking. I just thought, ‘Hey, maybe drinking will help.’ Because I felt alone and afraid,” he told the newspaper. “And you think, oh, this will ease the fear. And it doesn’t.”.

“One day I walked into a store and saw a little bottle of Jack Daniel’s. And then that voice —I call it the ‘lower power’ — goes, ‘Hey. Just a taste. Just one.’ I drank it, and there was that brief moment of ‘Oh, I’m OK!’ But it escalated so quickly. Within a week I was buying so many bottles I sounded like a wind chime walking down the street.”.

“You know, I was shameful, and you do stuff that causes disgust, and that’s hard to recover from. You can say, ‘I forgive you’ and all that stuff, but it’s not the same as recovering FROM it.”.

“Just as the gay rights movement only gained momentum when individual men and women summoned the courage to “come out,” I believe it is time for those of us who have struggled with depression to stand up and be counted.To understand depression and to reduce its stigma, we need to pull back the veil to show its familiar face”. “So I am officially coming out of the closet”.

. .

*My own after thoughts? Robins Williams death makes me feel some FEAR if I’m open and honest here. Is this what I have to look forward to because I live my life in recovery and battle mental illness? I can’t help but wonder, and makes me a bit edgy. . We can still learn a lot from a man who truly put into words his past battles with addiction, recovery, and severe depression. The answer to my question from my earlier post of the non-famous that passed away yesterday? The other nameless people who were NOT in the headlines, or made national news? HOW many nameless people die from mental/emotional illness’s & addictions by SUICIDE EVERYDAY? … Here is our ANSWER. .SUICIDE:Suicide (Latinsuicidium, from sui caedere, “to kill oneself”) is the act of intentionally causing one’s own death. Suicide is often committed out of despair, the cause of which is frequently attributed to a mental disorder such as depression, bipolar disorder, schizophrenia, borderline personality disorder,[1]alcoholism, or drug abuse.[2] Stress factors such as financial difficulties or troubles with interpersonal relationships often play a role. Efforts to prevent suicide include limiting access to firearms, treating mental illness and drug misuse, and improving economic development. Although crisis hotlines are common, there is little evidence for their effectiveness. .

Older age is associated with increased risk of suicide; people above the age of 65 are at the greatest risk for death by suicide. Approximately one million people commit suicide each year worldwide, that is about one death every 40 seconds or 3,000 per day. For each individual who takes his/her own life, at least 20 attempt to do so. Suicide has a global mortality rate of 16 per 100,000 people.

A study published in the August issue of the journal Addictionand summarized on PsychCentral by Richard Taite looked at the impact of second-hand trauma on later substance abuse. Researchers looked for traumatic medical events in the families of 1.4 million children born in Sweden between 1984 and 1995 by examining hospital discharge records. They were able to identify children who had a parent or a sibling who had been diagnosed with cancer or an immediate family member who suffered an injury which resulted in permanent disability or who had been a victim of assault or who had died. They then assigned each child a score of 0-4 depending on the amount of secondhand trauma s/he experienced. Then the researchers turned to medical, legal and pharmacy records to see which of these children were diagnosed with substance abuse problems when they reached their 20’s.

The researchers took care to control for other factors that might promote substance use, such as socioeconomic status, drug use by family members, psychological wellbeing and parents’ educational level. What they found was striking: Children who experienced even one of the four secondhand traumas under study had twice the risk of later drug abuse. Children who experienced the death of a parent were at greatest risk. Having a parent or sibling who was the victim of violent assault was the second most powerful factor. The PsychCentral report points out that “substance abuse was even higher in children whose siblings had experienced trauma than it was in children whose parents had been traumatized”. The authors of the study had high confidence in their findings since they were able to conduct annual sampling of a national population over a period 16 years and because they had access to multiple data sources in order to identify cases of substance use disorders.

Of course, previous studies have noted the impact of adverse childhood events (ACEs) on childrens’ emotional development. As I explained in another post researchers have found that people who endure a great deal of toxic stress spend much of their lives in fight, flight or fright. As the ACEs Too High Newsletter explained in October 2012:

“(These children) respond to the world as a place of constant danger. With their brains overloaded with stress hormones and unable to function appropriately, they can’t focus on learning. They fall behind in school or fail to develop healthy relationships with peers or create problems with teachers and principals because they are unable to trust adults. Some kids do all three. With despair, guilt and frustration pecking away at their psyches, they often find solace in food, alcohol, tobacco, methamphetamines, inappropriate sex, high-risk sports, and/or work and over-achievement. They don’t regard these coping methods as problems. Consciously or unconsciously, they use them as solutions to escape from depression, anxiety, anger, fear and shame. (http://goo.gl/VEl0ez) (Please continue reading)

Step 12..Carry the AA 12 Steps message of hope to the sick and suffering alcoholic, practice these principles in all my affairs. Live one day at a time on the Spiritual Path suggested that others may benefit from my daily reprieve. Is it about me or isn't it? Obviously this seems much more difficult than it really is. Too goody goody God like? Like it's great talk and talk is cheap. You can't be that good every day right? Saints? I mean for real not just in my own (I believe everything I think to validate myself) mind...Well, I have to say although it sure seems like it sometimes, I am not alone here in the Big Book 12 Steps. I've gotten quite used to the extreme self centeredness, the lions and tigers and bears.

The many who are willing to believe, willing to put the drink down with Steps 1 and 2 and understand the three pertinent ideas. And when ready, move ahead to their 3rd Step decision, express the idea, voicing it without reservation? Those who now have the new found Spiritual courage and strength to inventory their past from a new fearless moral standpoint in their 4th Step? Then have finally seen themselves and let their God know they knew the emotional distress and destruction they have caused..This is huge! Go on to surrender their defective character to their Spiritual Higher Power and clean up their past? Steps 5 6 7 8 9. Simply put, this is just how we roll. This is our whole new attitude and outlook on life. We are a reborn lot, not to be confused with a born again lot, for me anyway. We're sober today and willing to surrender ourselves to the power of the Spirit with each moment or like the Book's Step 10 suggests, constantly. Yes, following the Big Book 12 Steps and feeling myself thorough in my Step work to this point, Step 11 shows me everything I need to know about living one day without one drink. Everything to continue to grow in understanding and effectiveness in my sober life. I now have purpose, a reason for living. I can care enough about myself to be willing to take care of myself each day without some emotional enabler fancied or real. I am no longer the producer of confusion with the best of intentions. I have lost sufficient fear so life is no longer all about me, it's ok to just be a small part of it. I can survive, be valid without stealing a piece of everyone involved to create my emotional security. I am a real boy.

Without getting too morbid in my reflection it's safe to say I come from a pretty emotionally negative upbringing. Daddy had issues and passed them on to me. At 5 years old I was beat so bad I was never to be able to grow or participate...be a team player.. My life was over, shocked to the soul. I had been betrayed. I became stunted, self centered to the extreme. I jumped the track. I could not turn myself off now, there was no safe place for me now. Every minute of everyday was intense. I was afraid deep to my core. My head, my brain. Self centered fear was the norm. I could no longer hear and understand others, there was no listen and learn anymore. There was only tunnel vision of Daddy whipping me as I try to cover myself in the corner, am I good enough for Daddy, does Daddy approve, when will Daddy love me, nothing or no one else mattered. I began to treat others like Daddy would treat me. I saw his power over me and I wanted it over others. He loved me and I wanted to love others. In stead, I would make them pay for how I felt. My failures were your fault, if you can't fix me than the hell with you. Why didn't Daddy need to be fixed? Why was I the only failure? For the next 25 years life brought many empty relationships that began with the expectation that they would save me, fix me, make me happy, I would be could be normal, fulfilled even, happy.. They ended the same every time with me alone and broken. No new news here, same pain different faces. Whatever they had brought to me they left with. As much as I truly wanted to, I could not feel. I just could not risk it. I needed others to feel for me. I needed to fill my empty void of existence with others. I was always that beat five year old and sadly can still be today. Many many times and for long periods of time I wanted to die. Blubbering with my head in my hands. Many times I acted in ways that showed no concern for my life. I couldn't care. I was not capable of caring for myself. In my later teens and twenties when I became a drunk, that's all I was really. Just a drunk, a good for nothing drunk. All hat and no cattle. Hey! will somebody have sex with me and like me? Anybody? How about just talk to me? Notice me?

Every year 12,000 deaths occur in the US because of prescription drug abuse. This number has seen a staggering increase over the last couple of decades. The recreational use of prescription drugs is a serious problem with teens and young adults. National studies show that a teen is more likely to have abused a prescription drug than an illegal street drug.

Many consider prescription drugs safer because they are prescribed by a doctor, but that is just not true. Imbibing these medicines to get high, or using them to self-medicate can be dangerous.

Prescription drugs have serious health risks; this is exactly why they are taken under the instructions of a doctor. Despite being taken under medical guidance these drugs still present a high risk of addiction.

Fatalities occur everyday when people take a pill that they think looks like some other pill. The most important thing to understand is that everyone's body chemistry is different, and that different drugs affect people differently. A drug that would be okay for some could be fatal for others.

Types of Prescription Drugs Abused:

Depressants

These drugs are central nervous system depressants and slow down the function of the brain. These include sedatives and tranquilizers which make a person calm and drowsy.

These drugs are intended to reduce tension and anxiety in patients. They are also called downers and come in the form of multicolored tablets, capsules or as a liquid.

Some examples are Zyprexa, Seroquel and Haldol. They are known as antipsychotics and are supposed to reduce symptoms of mental illness. Depressants such as Xanax, Klonoping, Halcion and Librium are often referred to as "benzos". Barbiturates such as Amytal, Numbutal and Seconal, used as sedatives and sleeping pills, are also often abused.

Higher doses of these drugs can cause memory loss, impaired judgement and a lack of coordination. They have also been found to cause irritability, paranoia and suicidal thoughts. Many people experience the opposite effect, like agitation or aggression, than the one intended.

Using depressants with other substances, especially alcohol, can slow breathing and heart rate and can even lead to death.

Opioids

These drugs are painkillers and usually contain opium or opium-like substances, used to treat patients experiencing chronic pain. These drugs cause drowsiness, slowed breathing, constipation, unconsciousness, nausea, and in extreme cases even send a patient into coma.

Continued abuse of opioids can cause physical dependence and addiction. The body gets used to the presence of the drug and withdrawal symptoms can be observed if the use is reduced or stopped.

Withdrawal symptoms sometimes drive an addict towards abuse with renewed vigor. These symptoms can be restlessness, muscle and bone pain, insomnia, diarrhea, vomiting and cold flashes with goose bumps. Increased tolerance in users can mean increased doses, which can cause greater damage to the body.

Stimulants

These types of drugs are used to increase energy and alertness and also increase blood pressure, heart rate and breathing. These drugs are also called uppers -- cocaine and amphetamines are some examples of the same. These drugs can come in the form of tablets or capsules. Addicts usually swallow these pills or inject them in liquid form or crush and snort them.

These drugs can cause exhaustion, apathy and depression, and the down that follows the up provided by these drugs is usually quite severe. The immediate exhaustion after the high leads the user to want the drug again. Soon enough he forgets the high from the drug and all he tries to achieve is a feeling of normalcy.

Stimulants are dangerously addictive and repeated doses over short periods can lead to feelings of hostility and paranoia. They can also cause high body temperature and arrhythmia. Some examples are Ritalin, Concerta, Biphetamine and Dexedrine. Street names for these drugs can be Kibbles and bits, speed, truck drivers or black beauties.

Antidepressants

These are usually psychiatric drugs that handle depression. These drugs include Prozac, Celexa, Zoloft, Effexor and Remeron. They come as multicolored tablets or capsules. These drugs can cause nervousness, anxiety, irritability, violent thoughts, tremors and hostility among others. Some studies have also found a high correlation with aggression and criminal behavior.

A study found that 14% of young people taking antidepressants become aggressive and in some cases even violent. These drugs can also cause extreme and irrational behavior. Individuals with no history of violence begin to show aggressive and self-harming behavior. Withdrawal symptoms of this drug are also quite severe and can include anxiety, depression, weeping spells, insomnia, dizziness, vomiting, headaches and tremors.

Symptoms of Prescription Drug Abuse:

Opioids – Abusers of these types of drugs will usually experience constipation, depression and low blood pressure. They will also find their breathing shallower than that of non-addicts, and will often experience confusion, sweating and poor coordination.

Antidepressants – Drowsiness, confusion and an unsteady gait are among the prime symptoms experienced by an antidepressant abuser. They often experience poor judgement, involuntary movement of the eyeballs and dizziness.

Stimulants – Those abusing stimulants will see rapid weight loss, increased agitation, irritability and high blood pressure. They will have trouble sleeping, have an irregular heartbeat, restlessness and be victims of impulsive behavior.

Those addicted to prescription medication will often resort to stealing, forging and selling prescriptions to get a fix. Those taking higher doses than prescribed can also be noted as addicts. They will have regular mood swings and more often than not be hostile. They will have erratic sleep cycles and often have impaired decision making skills. Prescription drug abusers often pretend to lose prescriptions and use that as an excuse to get more written. They also tend to visit more than one doctor for a prescription.

Prescription drug abuse is a disease. If you are facing abuse by such an addict get in touch with a dangerous drugs lawyer in Raleigh for a free initial counsel. Those taking more than the medically advised dosage of prescription drugs may not be able to claim damages from the drug manufacturer in case of adverse side-effects.

Self-medicating can be a dangerous habit, so make sure that you follow your doctor's instructions when taking prescription medicines. Keep an eye on the prescription drugs you keep in your house and inform the young adults in your care about their side-effects. Drugs, while beneficial in the hands of a doctor, can be dangerous in the hands of someone just looking for a kick.

As ‘Gamblers Anonymous’ tells us, “We can recover from compulsive gambling without knowing the reasons why we gambled and became addicted in the first place” might be true. But there are some like myself who know a little of why we did …

. .But like my last blog post said, sometimes if look dig a little deeper, we can find some of the issues in our life that lead us to take a dark path to cope, escape, and try to delete past issues and pains. Yes, many say it might be an excuse, rationalizing, blaming other people, places, or things on OUR CHOICES. I don’t agree. I DID NOT CHOICE to become an addict. Addiction isn’t always about CHOICE ….

Well to those who have NO clue, no experience of being an addict of any type, nor been touched by addiction or someone they know or love has, then I say, ….YOU HAVE NO IDEA WHAT IT’S LIKE to be held hostage by any addiction. We all don’t get tangled up with addiction by CHOICE. Through treatment, therapy, or the personal inside work on all our character defects, and working through the 12-steps, we DO sometimes find a few reasons WHY we went down that dark path of addiction. Is it really too much to ask of the public to have a wee bit more understanding and compassion of what it’s like to be addicted to some type of addiction? Is IGNORANCE still that prevalent in our society? Sadly yes when it comes to addictions and Stigma around us who live life in Recovery!

. . See, for my own addictions of compulsive addicted gambling and alcohol abuse when I gambled, I found doing the work within side myself, and through therapy with a psychiatrist I found I was suffering from undiagnosed bipolar 2 severe depression, mild anxiety mania, bipolar cycle insomnia, and the ‘pleasure & reward’ part of my brain was effected from the years of the repetitive behaviors of addicted gambling. Then later effects of agoraphobia with panic settled in, another direct effect from my years of addicted gambling. . All these mental & emotional disorders I still battle today. It was the addicted gambling that brought out the bipolar symptoms to the surface when sent to a crisis center the first time.

I know all this sounds complex, then add my past childhood abuse & traumatic events that happened to me, I learned very well to stuff all that away for a very long time. But it did come back to haunt me, and I started using gambling as my escape, and a coping skill to not FEEL all that I endured as a little girl. I began having nightmares again, and didn’t know the proper way to process all this hurtful stuff. I’d done a good job pretending I was normal, and none of those things really happened to me.

More and more families are confronted with the realization that a loved one is using drugs or alcohol. And few know what to do or where to turn and are afraid to ask anyone because they feel ashamed, confused and guilty that they are somehow to blame.

I was among them when my son, Steven, became one of those growing statistics. I lost him and vowed to do something to help others so they would not have to know the grief and despair my family has.

Steven grew up in a loving home with two brothers, parents that loved him and more love than anyone could ask for. He was well behaved and extremely respectful.

The problem of dual diagnosis & diseases of addiction have a comorbidity rate of 53% and climbing each year. One newer study suggests the rate of this comorbidity of both illnesses is actually closer to 2/3rds of people with depression who also have substance abuse/addiction problems. The connection between those who have addiction and are depressed is so strong and an unavoidable problem when it comes to treatment, that people are quick to believe and perceive that it is the addiction which is causing the depression. The newest evidence has shown that quite the opposite happens in many instances. It's like the old what came fist the chicken or the egg theory; And with addiction & depression/mental illness, it is not that simple a question to answer, but there are some answers that help doctors every day to diagnose and decide which is the primary illness and which is the secondary or if they co-exist.

There are 3 types of groups which are studied under the Mental Health & Drug Abuse Coalition. The 1st, is people who have depression or other mental illness, may seek help but find what they are given is not working, so they begin to experiment with other ways to alleviate their symptoms, such as alcohol and drugs, leading quickly to an addiction once the patient feels the substance has "cured" their symptoms. It is the very well-known phrase of "self-medicating" which was actually a term and theory first coined by a few doctors which included the author of many books on the subject of "self-medicating" with opiates, alcohol, cocaine & other drugs, Doctor Edward Khantzian, a psychiatrist from Haverhill Massachusetts, and a Clinical Professor of Psychiatry at Harvard University, who first published this hypothesis of self-medicating with heroin for depression in a 1985 paper, which expanded until it was accepted as a true theory and still used today to explain diagnosis & treatment. In this case it is shown that a person had an onset FIRST of mental illness, and then the drug addiction came next.

The 2nd group is those who are people who are chronic drug abusers, ie: addicts. They use their drug of choice daily and over time, they begin to develop mental illness symptoms, causing them to then increase their use and making it very difficult to stop. This group of people are difficult to convince to access treatment or professional help, because they are usually so afraid of trying to seek treatment for the depression, for the sole purpose of being scared that their addiction will be be discovered. Certain drugs, almost all of them, including ecstasy, alcohol, opiates, methamphetamine, cocaine & more, have been shown in advanced clinical research, including brain scans of addicts, with results showing that their drug use has directly caused malfunctions in major centers of the brain where a person's impulse control, emotion regularity, reasoning, cognitive ability and many more areas are damaged by the chronic drug use. So this group usually begins with trying different illicit or pharmaceutical drugs. finding one they like, and after chronic, daily use, their brains are actually being damaged on many levels, in many areas by the very drug they use. So first the drug addiction starts, and then sets in the mental illness symptoms, like depression & anxiety, bipolar and many others.

The 3rd group of people are those who have co-occurring conditions that are ongoing and increase in severity. The drugs do not alleviate the depression, anxiety, or other mental illness symptoms quite well enough to consider themselves in good mental health, but the substance abuse has already caused further damage to their brains in many areas, making it that they are the hardest group of patients to treat. They are however, the people who are most likely TO seek treatment for both illnesses, knowing very well they both exist at all times and are aware of it daily. The usually might begin by asserting or believing that their depression, low mood, anxiety, panic attacks, loneliness, bouts of crying for no apparent reason, mania, hypomania, isolation, etc are all directly the result of being forced to stop their drug of choice or attempt to stop on their own. They attribute these mental and mood changes to withdrawal, but they aren't; in fact it is that they DO now have a very clear diagnosable mental illness caused by the changes in their brains from the chronic drug use and since they have stopped using these drugs, the symptoms are now more present and bothersome than ever before. So this group already had mental illness but was made much worse by chronic long-term drug use.

When patients with dual-diagnosis are treated they have a fairly good rate of recovery IF they adhere to taking medications and make serious changes in their lifestyles. When you have such chronic drug abuse and depression it is hard for doctors to decipher which symptoms are causing the other so dual diagnosis treatment first is used to detoxify the patient from the drugs and stabilize them so they are not in pain. Once this is done they can begin to introduce therapeutic programs as well as medications for bipolar, depression, anxiety or any other mental illness, as is indicated. They are monitored closely throughout every 24 hour period, their vitals checked for stability, dosages changed daily if that needs to be done, and the patient upon release is given very specific and easy to follow directions for returning home. This typically includes an intake for an intensive outpatient program (IOP), meeting schedules, individual therapy set-up, follow up appointments with doctors and if needed, an appointment with a clinic for continued use of subutex or suboxone.